With the news of Big’s devastating fatal heart attack in the first episode of the Sex and the City reboot, And Just Like That, we need to talk about something super important: What to do if you or a loved one has a heart attack. 

Carrie is stunned when she comes home to find Big sitting slumped against the shower wall, and she seems almost frozen for a moment, unsure what's happening or what to do before she rushes to his side in a scene we’re still crying over.

While that’s a terrifying prospect, and Carrie’s shock was totally to be expected (I mean, I’d probably act the same in her situation), the plot point nonetheless got us thinking: What do you actually do in this situation, if you come home and find your partner slumped on the floor, barely conscious? And what do you do if you realize *you* might be having a heart attack and no one’s home to help?

What to do in case of a heart attack

If you think you or a loved one may be having a heart attack, according to Bayer Aspirin, take these two steps immediately:

  1. Call 911
  2. Chew or crush and swallow an aspirin tablet 

Once medical support is on the way, chewing or crushing and swallowing an aspirin tablet can buy you precious time. Aspirin works to prevent blood clotting factors known as platelets, and taking it in the moments following the first signs of a heart attack can help blood continue flowing if there’s a blockage and protect against more damage.

"Time is critical during a suspected heart attack, so chewing and swallowing aspirin helps it get into the bloodstream faster. It then works to keep blood flowing and can help prevent further damage to the heart, increasing chances of survival," says Daniel Romaikin, senior medical manager of Bayer Aspirin.

"The typical recommended dose of aspirin during a heart attack ranges from 160 to 325 milligrams," notes Romaikin. "This would be two to four tablets of low-dose aspirin [81 mg per tablet], though it is important to always follow your healthcare professional’s specific instructions when using aspirin in the event of a suspected heart attack."

According to one study, chewing a 325 mg tablet (or 4 low-dose aspirin tablets) of non-enteric coated aspirin can reduce your platelet activity by 50% in just five minutes. 

Here’s the thing: If Carrie had called 911 immediately as soon as she saw Big, they likely would have told her to take this step on the phone. Having had a prior cardiac episode in season six, Big maybe would’ve had aspirin on hand at home. This step could’ve—maybe—saved his life. And while it’s too late for Big, it’s not too late to learn an important lesson from his untimely demise. RIP, JJP.

Signs and symptoms of a heart attack

Heart attacks tend to be marked by these common symptoms, though there’s no such thing as a typical heart attack. In both men and women, the cardinal warning sign is chest tightness and pain or discomfort, though those feelings may come and go. 

  • Chest tightness and pain
  • Pain in the arms, back, neck or jaw
  • Paleness
  • Lightheadedness
  • Sweating
  • Nausea 
  • Extreme fatigue

Women tend to experience different heart attack symptoms than men. In many cases, the chest pain may feel less severe. Women also more commonly experience nausea and excessive fatigue in a heart attack, as well as pain in both arms (instead of just one arm, as many men experience), plus sleep issues. 

In general, women tend to downplay heart attack symptoms or ignore them entirely. But the sooner you report an issue, the better chance you have of treating the underlying cause before it becomes something bigger.